How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees; Comment on “Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis”

1Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany

2Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany

Abstract

Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis – not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens’ right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call “globalization within.” Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof.